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To summarize clinical application results of repair soft tissue defect in forefoot with a reversed lateral soleus muscle flap on peroneal artery pedicle.From January 2005 to January 2013, 8 patients with soft-tissue defect on forefoot were underwent reconstruction with a reversed lateral soleus muscle flap on peroneal artery pedicle. There were 6 males and 2 female, aged from 16 to 48 years with an average of 26.8 years old. The reversed lateral soleus muscle flap was transposed to the forefoot defect area, then immediate coverage of the muscle flaps were performed by a meshed split-thickness free skin graft. The donor site was closed directly. The muscle flap survey was observed after the repair of the forefoot.All muscle flaps had survived completely. No clinical vascular deficiency was found on muscle flaps postoperatively. One case occurred recipient area sustained insignificant superficial infection, one patient developed distal muscle flap small skin graft necrosis, and spontaneous heal by 2 weeks' change dressing. Follow-up period was ranged form 2.5 to 5.5 years with an average of 3.5 years postoperatively. A good contour was confirmed at the recipient area. According to Cedell questionnaire, 6 patients obtained good results and 2 fair.When the local skin flap or muscle flap application is limited, lateral soleus muscle flap survey is satisfactory after repair and very suitable for repair of soft tissue defect of forefoot.

To summarize clinical results of the microdecompression for the treatment of intraforaminal lumbar disc herniations.From September 2005 to May 2013,16 patients( 12 males, 4 females)with intraforaminal lumbar disc herniations underwent microdecompression, ranging in age from 32 to 56 years old with a mean of 38.6 years old. The lumbar disc herniations were located at L(3,4). in one patient, L(4,5) in 10 cases and L5S1 in 5 cases.All the patients were followed up, and the duration ranged from 20 to 48 months, with a mean period of 36 months. According to Macnab evaluation, 12 cases got an excellent result, 4 good. No apparent complications related to the technique occurred. Satisfactory clinical results were obtained in this series.Microdecompression may be particularly useful in the treatment of intraforaminal lumbar disc herniations. The microdecompression procedures are more likely to be well tolerated by older patients.

To summarize clinical result of the modified posterior approach for the treatment of the mid and distal segment humeral fractures.Between January 2006 and December 2010, 26 patients with the mid and distal segment humeral fractures were treated with the open reduction and plate fixation by the modified posterior approach including 17 males and 9 females with an average of (37.1±1.5) years old ranging from 24 to 50 years old. The time from humeral fractures to operation were from 8 hours to 6 days with an average of (3.3±0.6) d. The elbow function were assessed by Morrey-Bryan.There was no procedure related complications occurred. No neurologic injury and wound infection after operation occurred. All patients were followed up from 22 to 48 months with an average of (30.1±1.6) months. The humeral fractures were confirmed healing. The clinical results of Morrey and Bryan were excellent in 19 cases (94.6±1.8), good in 7 cases (86.5±1.2).The modified posterior approach avoided injury of triceps muscle and improved postoperative triceps function. The technique may be particularly useful in the treatment of the mid and distal segment humeral fractures.

To summarize the clinical application results of the repair soft tissue defect in contralateral leg with a cross-leg soleus muscle flap pedicle transplantation.From January 2008 to January 2013, 8 patients with soft-tissue defect in lower leg underwent reconstruction with a cross-leg soleus muscle flap pedicle transplantation (without microvascular anastomoses). There were 7 males and 1 female, aged from 20 to 49 years old with an average of 31.8 years. The operative time after injury was from 2 to 8 weeks with the mean of 46 days. The soleus muscle flap was transposed across to the contralateral leg defect area, then immediate to perform the coverage of the muscle flaps by a meshed split-thickness skin graft. The donor site was closed directly.All the muscle flaps had survived completely. In one case, recipient area edge had a less exudate from drainage hole everyday, the incision spontaneously was healed after 2 week's changing dressing. Follow-up period ranged form 1.5 to 4 years with an average of 2.5 years postoperatively. The tibia and fibula fractures were healed well. A good contour was achieved at the recipient area. According to LEM standard, 2 cases got excellent results, 5 good and 1 fair.Soleus flap pedicle transplantation is very suitable to repair the soft tissue defect of the injuried leg only one main blood vessel, and can reduce the damage of donor area.

To report the clinical application results of free deep inferior epigastric perforator flap in the repair of soft tissue defect.From January 2006 to January 2012,13 patients with soft tissue defect (7 cases in leg and 6 cases in forearm) underwent reconstruction with a free deep inferior epigastric perforator flap. There were 9 males and 4 females, aged from 21 to 45 years old with an average of 33 years. Soft tissue defect in the extremities were from 7 cm x 17 cm to 8 cm x 26 cm. The medial branch and lateral brangh flaps were 7 cases and 6 cases respectively. The donor site was closed directly.One patient developed small wound dehiscence, which spontaneous healed at one month after surgery. All the flaps had survived completely. Follow-up period ranged from 1.8 to 4.0 years with the mean of 2.8 years postoperatively. Satisfactory clinical results were obtained in 12 cases. A good contour was confirmed at the recipient area.The free deep inferior epigastric perforator flap for the extremities defects of soft tissue is a good option. This technique is safe and reliable, and can decrease the injury of donor site.

To summarize the clinical application result of the selective nerve root blocks in limited operation of the lumbar spine.From January 2008 to October 2012,68 patients with lumbar spinal canal stenosis with multiple levels were underwent the selective nerve root blocks in limited operation of the lumbar spine,including 47 males and 21 females with an average age of 56 years old ranging from 45 to 80. After never roots blocks,64 cases were positive for limited operation of the lumbar spine; the other 4 cases were negative and abort the operation.The nerve roots block operation smoothly and no complications related to the nerve roots block occurred. There was no neurologic injury complication in this study. Follow-up period ranged from 16 to 45 months postoperatively (means, 32 months). The recovery effect was calculated with Macnab scores, the result was excellent in 44 cases, good in 18 cases, poor in 1.Operative treatment for lumbar spinal canal stenosis with multiple levels is focused on the areas causing symptomate neural compression rather than prophylactic decompression at areas of nonsymptomatic disease. Application of selective nerve root blocks can accurately judge the responsible vertebral body and pain source and improve the curative effect of limited operation of the lumbar spine

To summarize clinical application results of repairing soft tissue defect in lower leg with a bridge shaped medial hemisleus muscle flap pedicle transplantation.From January 2008 to January 2012,12 patients with soft-tissue defect in lower leg underwent reconstruction with a bridge shaped medial hemisleus muscle flap pedicle transplantation. There were 8 males and 4 females with an average age of 34 years old ranging from 22 to 50 years old. Time after injury was from 2 to 12 weeks (means, 3.5 weeks ). The immediate coverage of the muscle flaps were performed by a meshed split-thickness skin graft. The donor site was closed directly.All the muscle flaps had survived completely. Follow-up period ranged form 1.8 to 4.0 years (means, 2.8 years) postoperatively. The tibia and fibula fractures were confirmed healing. A good contour was confirmed at the recipient area. The results were evaluated with LEM questionnaire, excellent results were obtained in 6 cases, good in 5 cases and fair in 1 case. Satisfactory clinical results were obtained in 11 cases.This technique is particularly useful for repairing soft tissue defect in the injured leg when only one vessel remains, and can reduce injury to donor site.

Percutaneous vertebroplasty(PVP), among various other options,has become a mainstay in the management of osteoporotic compression vertebral fractures. The purpose of this article is to review complications arising from the procedure and describes methods to minimize them. Complications can be classified as mild,which may include a temporary increase in pain; transient hypotension and cement leakage in the intervertebral disc space or into paravertebral soft tissues, moderate, including infection; extravasation of cement into the foraminal or epidural space and severe such as cement leakage in the paravertebral veins, leading to pulmonary embolism, cardiac perforation, cerebral embolism or even death.

To summarize clinical outcomes of using medial transposition of the radial nerve in humeral shaft fracture fixation.From January 2005 to December 2009, 16 patients with humeral shaft fractures were treated with medial transposition of the radial nerve during open reduction and anterolateral plate fixation, included 12 males and 4 females ranging in age from 26 to 49 years, with a mean of 36 years. There were 7 fractures in the right and 9 in the left. According to AO classification, 6 fractures were type A3.2, 5 fractures were type A2.2, 2 fractures were type A1.2 and 3 fractures were type B2.2. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS), where 0 indicates normal upper extremity function, and 1 to 100 indicate varying degrees of damage to the function of the upper extremities.There was no neurologic complication or postoperative would infection in this series. The followed-up period ranged from 20 to 46 (means 29) months postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, indicating that all patients reached a normal value (value of 0). The function of the upper extremities recovered satisfactorily. There was no surgery-related complication.Medial transposition of the radial nerve is safe and does not cause iatrogenic nerve injury. It protects the radial nerve during open reduction and anterolateral plate fixation of humeral shaft fractures.

Nonunion of the tibia fracture may be caused by local infection, soft tissue defect,bone defect,fracture malaignment,bone marrow cavity block and degree of injury and so on. For less complications, central bone grafting is better than other methods for the treatment of selected nonunions of the tibia fracture. This procedure is performed through lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula and the nonunion of the tibia at top and below. Application of internal fixation is beneficial to correct deformity and promote fracture healing. Central bone grafting is a safe and effective treatment for nonunions of the tibia.

To summarize the clinical application results of the micro-decompression procedure for the treatment of lumbar spinal stenosis with multilevel.From January 2004 to December 2008, 40 patients with lumbar spinal stenosis with multilevel were treated by micro-decompression procedure. There were 28 males and 12 females, ranging in ages from 55 to 80 years,with an average of 58 years. The course of this disease ranged from 18 months to 12 years,averaged 32 months. Forty patients with lumbar spinal stenosis with multilevel were diagnosed by CT or MRI examination. There were 20 cases with two levels stenosis (L4,5 and L5S1), 15 cases with three levels stenosis (L3,4, L4,5 and L5S1), and 5 cases with four levels stenosis (L2,3, L3,4, L4,5 and L5S1). The therapeutic effects were evaluated according MacNab standard in aspect of pain, bladder function, range of lumbar spine motion and muscle strength of lower limb.All of the incisions healed without infections and complications. The mean operation time of each side was 70 minutes (ranged from 50 to 90 minutes), and mean blood loss was 150 ml (ranged from 90 to 200 ml). All the patients were followed up from 22 to 52 months with an average of 26 months. According to MacNab standard, 28 cases got an excellent result, 10 good and 2 poor.Operative treatment for lumbar spinal stenosis with multilevel should focus on the symptom sites causing by neural compression and preventive decompression operations are not necessary for nonsymptomatic sites. The micro-decompression procedure can be easily tolerated by older patients;it can decrease the damage to the posterior stabilizing structures of the lumbar spine. It is easily to access to spinal canal and decompress the nerve roots.

To investigate the application of free anterior serratus musculo-fascial flap in bridge style for the soft tissue defect at leg.From Sept. 2006 to Jan. 2009, the free anterior serratus musculo-fascial flaps were used in bridge style in 7 cases with soft tissue defects at legs. The anterior serratus musculo-fascial flaps were elevated with subscapular and circumflex scapular vessels forming a T-shaped vascular pedicles. The T-shaped pedicle was end-to-end anastomosed with the two ends of the posterior tibial artery at the healthy leg. The musculo-fascial flap and its pedicle were covered with skin graft.All the 7 flaps survived completely with satisfactory result. The patients were followed up for 9-42 months with good functional and esthetic result both in donor site and recipient site. The patency of posterior tibial artery was demonstrated by clinical and Doppler examination.This technique is particularly useful in leg reconstructive surgery when only one vessel remains. The patency of the posterior tibial artery at the healthy leg is preserved and the morbidity in donor site is minimal.

Fracture of the subtrochanteric area of the femur is one of the most difficult about the hip to manage. Many of these fractures are comminuted and result from high-energy trauma. Nonoperative treatment of these fractures may result in a significant rate of malunion, nonunion and other complications. Therefore, subtrochanteric fractures is preferred to be treated with operative methods. The Russell-Taylor classification is useful in planning the type of internal fixation. For fractures located below the level of the lesser trochanter, standard locked intramedullary nails can be used effectively. For fractures that extend into the lesser trochanter but do not involve the piriformis fossa, the options of a cephalomedullary nail versus a 95 degree fixed angle device have yielded the best results. For fractures that have proximal trochanteric extension into the area of the piriformis fossa, sliding nail screw devices may have some usefulness. The DHS implant is not employed for the treatment of subtrochanteric femoral fractures.

To summarize clinical application of the distal island muscle flap of the gastrocnemius muscle for repairing the defects around knee and within the upper 2/3 of lower leg.18 patients with defects around knee and within the upper 2/3 of lower leg, were treated with the distal island muscle flap of the gastrocnemius muscle, including 12 cases with medial muscle head and 6 cases with lateral muscle head. The muscular flaps were covered with meshed split-thickness skin grafts. The wound at donor sites were closed directly.All the skin grafts and muscle flaps survived with superior infection at the wound edge in two cases. The patients were followed up for 8 months to 4.8 years with satisfactory cosmetic and functional results.The distal island muscle flap of the gastrocnemius muscle has a reliable blood supply, long pedicle and suitable thickness. It is an ideal method for repairing the defects around knee and within the upper 2/3 of lower leg.

To analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and long-term efficacy.From June 2005 to January 2009, 46 patients with distal radius fractures were treated by surgical operation including 17 males and 29 females,ranging from 27 to 90 years old with an average age of 48 years. All fractures were reduced satisfactory with smooth articular surface. The postoperative radial shortening was analyzed.All patients were followed-up for 6 to 24 months with an average of 14 months. Among them, 12 patients had radial shortening. The causes of postoperative radial shortening includes: (1) patients older than 60 years; (2) severe osteoporosis; (3) preoperative displacement and comminuted fractures; (4) inappropriate fixation methods; (5) inadequate bone graft; (6) premature load.The key points to enhance the treatment outcomes include precise judgement of the fracture type and bone quality, sufficient bone graft, firmly fixed after anatomical reduction and an appropriate plan for early loadless functional exercise. Traumatic arthritis may be avoided or delayed if the above-mentioned six causes can be taken into consideration or preventive measures can be taken.

The spine is the most common site of metastatic tumors. The highest incidence of metastatic tumors on the spine is in the lumbar region, followed by the thoracic and cervical levels. Most associated spinal cord lesions, however, are located in the thoracic spine. The goals of surgery is decompression of the neural tissues, prevention of neural injury by stabilization of the unstable spinal column,or pain control. When there is a need to decompress the neurologic tissues,the most direct approach is anterior because the most common site of metastatic tumors is in the vertebral body. Laminectomy alone is not effective in improving neurologic function. Nevertheless,the posterior approach is more accessible, less hazardous, and effective in the correction of deformity if combined with instrumentation. If complete vertebrectomy is feasible in anterior bone strut combined with anterior and posterior stabilization is necessary following the vertebrectomy.

To explore operative effect of lumbar intervertebral disc herniation accompanying with lumbar instability.Form June 2000 to June 2006, 46 patients of lumbar intervertebral disc herniation accompanying with lumbar instability were treated with decompression through posterior approach, diskectomy, spinal fusion and vertebral pedicle internal fixation. Including 33 males and 13 females,the age was from 37 to 68 years with an average of 48 years. The course of disease was from 4 months to 20 years with an average of 3.5 years. There were simple segment in 21 cases, double segments in 22 cases, three segments in 3 cases.All patients were followed up for 12-45 months with an average of 25 months. All cases got solid fusion and clinical symptom improved obviously. According to clinical standard to evaluation, 32 cases obtained excellent result, 8 good, 6 fair. The rate of excellent and good was 86.9%.Diskectomy, spinal fusion and internal fixation can obtain satisfactory clinical effect for lumbar intervertebral disc herniation accompanying with lumbar instability.

Locking plate technology offers improved fixation stability in osteopenic bone and for comminuted and periarticular fractures. The additional stability per screw compared with that of conventional nonlocking fixation enhances the application of minimally invasive fracture techniques. The application of locking plates is somewhat more difficult than the placement of conventional plates. Fracture reductions are often done indirectly, the locking screw must be carefully aligned along the axis of the receiving hole to ensure proper tightness, and the length of the plate must be selected carefully. The use of locking plates will likely increase, particularly with the increasing prevalence of osteopenic fractures on our aging population and the increase in high-energy fractures in younger patients severe trauma.

To summarize clinical application result of the thoracodorsal artery perforator pedicled flap for repair of soft tissue defects on the ipsilateral upper limb.From September 2003 to May 2007, 8 patients (6 males and 2 females) with soft tissue defects on the ipsilateral upper limb underwent reconstruction with the thoracodorsal artery perforator pedicled flap. The age of patients was from 16- to 45-years-old with an average of 32 years. Of them, the recipient sites of 5 cases were located on the arm region, 3 cases on the forearm.The minor superficial infection of 1 case occurred on the recipient site after operation and the wound gradually healed by daily change dressings. All the flaps had survived completely and the postoperative course was uneventful with satisfactory clinical results. Follow-up period ranged for 9-38 months after operation (mean, 19 months). There was no remarkable donor site morbidity. All cases had good appearance on recipient site.The thoracodorsal artery perforator pedicled flap is thin and suitable for repair of soft tissue defect on the ipsilateral upper limb.

This article reviews the history and development of as well as the results using a fibular graft by vascular anastomosis for the treatment of avascular osteonecrosis of the femoral head. Vascular anastomosed fibular grafting has been reported to be successful for patients with early stages and precollapse osteonecrosis of the femoral head. The method can be used to preserve the hip joint function. Vascular anastomosed fibular grafting can be the transfer of vascularized bone grafts into the necrotic portions of the femoral head. Such a procedure, in addition to replacing necrotic bone with healthy bone, also establishes a new source of circulating blood of the femoral head. Free avascularized bone grafting for the treatment of avascular osteonecrosis of the femoral head may lead to higher rates of successful treatment and superior to those of core decompression and nonoperative treatment.

Segmental bone defects are very severe in open fractures of the lower extremity. Traditional treatment requires skeletal stabilization, usually by external fixation, followed by free tissue transfer for soft tissue coverage, and vascularized or nonvascularized bone grafting for the skeletal defect. The bone transport distraction osteogenesis is a new method for treating bone defects. The range of bone loss for which bone transport is indicated 3 to 12 cm. The method required only small bone grafts to stimulate healing at the bone defect site, whereas patients in the conventionally treated group needed a larger volume of cancellous bone graft. Donor site morbidity was less in the method, and no free-tissue transfers were required. Disadvantages of the method was a complex, time-consuming reconstruction. In the appropriately selected patient, when the surgeon is experienced in the technique, treatment by bone transport distraction osteogenesis offers unique advantages for certain cases of the bone defect.

To report the clinical results of scalp defect using V-Y-S rotation flap.From March 2003 to October 2005, 5 cases scalp defect (4 male, 1 female) were reconstructed with the technique. The age ranged from 26 to 52 years (mean 32 years). The scalp defect ranged from 3 cmx3.5 cm to 4 cmx5 cm. Four cases were reconstructed with bilateral flap and one case was reconstructed with unilateral flaps.All patients were followed-up from 10 to 42 months (mean, 28 months). All the flaps survived completely and showed good hair growth and had satisfactory clinical results.Repair of scalp defect using V-Y-S rotation flap technique is simple with no need for a skin graft and can be performed quickly, there is minimal morbidity and the outcome is highly successful.

To summarize clinical application of the sural medial gastrocnemius island muscle flap to cover wound of infection on upper region of the tibial.Nine patients (7 men, 2 women) with soft tissue defects on the upper region of the tibial underwent reconstruction with the sural medial gastrocnemius island muscle flap. The age ranged from 21 to 60 years old (mean, 34 years). The immediate coverage of the muscle flaps were performed by a meshed split-thickness skin graft. The donor site was closed directly. The donor leg was ipsilateral in all cases.Only one case sustained superficial infection postoperative and the gradual wound healed by daily wound dressings. All the muscle flaps and skin graft had survived completely without major complication with satisfactory clinical results. All patients were followed-up for 13 months to 4 years (mean 21 months), the donor site was healing, there was no remarkable donor site morbidity.The sural medial gastrocnemius island muscle flap is nourished by the medial sural artery. The muscle flaps seem to have highly vascularize, a constant vascular anatomy and a long vascular pedicle. The muscle flap is thin and suitable for repairing soft tissue defect on the upper region of the tibial.

Avascular osteonecrosis of the femoral head is a common disease in orthopedic clinics. If the diagnosis can be made before collapse of the femoral head, the hip joint may probably be preserved by means of core decompression with or without bone grafting, osteotomies, as well as nonvascularized or vascularized bone grafting. Local pedicled bone grafts and free vascularized bone grafts can transfer the vascularized bone grafts into the necrotic area of the femoral head, which not only can replace necrotic bone with healthy bone, but also establish a new source of blood supply to the femoral head. The success rate in patients with different stages of osteonecrosis of femoral head was 80% at 5 years follow up. Free vascularized bone grafting for the treatment of avascular osteonecrosis of the femoral head can obtain a higher success rate.

To summarize clinical application experience of treatment of occluded iliofemoral veins with great saphenous vein cross-over bypasses.From September 1998 to December 2005,6 patients(5 men, 1 woman) with occluded iliofemoral veins underwent great saphenous vein cross-over bypasses. They ranged in age from 36 to 52 years (mean, 41 years old). All patients had unilateral thigh and leg edema and swelling with accompanying pain. The normal contralateral great saphenous vein was dissected and it was tunneled across the super-pubic fat pad and anastomosed to the femoral vein or the proximal portion of great saphenous vein in distal to occluded iliofemoral veins.The postoperative course was uneventful. One case sustained superficial infection postoperatively at donor site and the gradual wound healed by daily wound dressings. At 1 to 3.5 years (mean 1.8 years) followed up, all patients had pain disappearance and obvious relief of the edema but some swelling.Great saphenous vein cross-over bypasses is effective operative method of treatment of occluded iliofemoral veins. The operation is relatively simple and safe.

To summarize clinical application of one-stage toenail lengthening in free second toe transfer for reconstruction of the thumb (finger).Nine patients (male 7, female 2) underwent thumb (finger) reconstruction with second toe transfer were treated by one-stage toenail lengthening technique. Eight were the thumb and 1 was the index finger. Patients aged from 18 to 46 years,with an average of 25 years. A rectangle skin was resected at 0.5 cm away from the eponychium, which was 0.2 cm high and as wide as the toenail. Then stripped U shape flap gently towards proximal end and sutured it. During the operation, the injury of the subcutaneous vascular network should be avoided.Superficial infection at donor area happened in 1 case and was healed by changing dressings. All the reconstruction thumbs (fingers) had survived completely. 2 to 3 mm extending of toenail length was obtained and the appearance of thumb (finger) was improved. There was no growth deformation of toenail. After 7 to 24 months follow up (the average time 13 months), the appearance of the nail was good.One-stage toenail lengthening in free second toe transfer for reconstruction of the thumb (finger), which can obtain a satisfactory appearance of the nail and have no influence on the motion of the reconstruction thumb (finger), is a simple and an effective operative procedure.

The coverage of large soft tissue defects in heel is a problem for surgical reconstruction. Various reconstructive materials are available depending on the location, size and depth of heel defect, but unique function of heel skin cannot be restored easily by means of reconstruction. We used prefabricated flap of the foot heel to cover heel defect in a child and obtained satisfactory clinical results.

To evaluate the clinical application of microsurgical fascia latae flaps combined with rib and skin graft for reconstruction of the distal phalanx defect.The phalanx wounds were sutured together like syndactyly. The autologous rib was revised to repair the bone defect of distal phalanx. The fascia latae flap was used to cover the bone exposure with microvascular anastomoses and resurfaced by a meshed split-thickness skin graft.5 cases were treated successfully. The fascia latae flaps were all survived with only skin graft necrosis at the distal end in one case. It was healed spontaneously.The fascia latae flap is nourished by the descending branch of the lateral circumflex femoral artery. The flaps has a good blood supply and can be easily obtained with a long vascular pedicle. The flap is ideal for the reconstruction of distal phalanx defect when combined with autologous rib implant and skin graft.

To report the clinical results of the repair of soft-tissue defect of amputation stumps of the forearm with free flap from the traumatic amputated extremity.Five patients, 4 males and 1 female, aged 32 (22 - 43), with soft-tissue defect of the remaining stump of the traumatic amputation of the forearm, 3 cases in the right forearm and 2 cases in the left forearm, underwent repair of the defect by free flap from the traumatic amputated extremity with the size of the flaps ranging from 8 cm x 9 cm to 9 cm x 12 cm. The patients were followed up for 2.6 years (1.5 - 3.5 years).Superficial infection occurred in one patient postoperatively and the wound was gradually healed by daily wound dressings. All the flaps survived completely with satisfactory clinical results. The cosmetic appearance on the recipient area was good and the function of the elbow recovered satisfactorily.The flap from the traumatic amputated extremity has a constant vascular anatomy and a long vascular pedicle, so that dissection of the flap can be accomplished easily. The surgery allows to preserve the functional length or the elbow function of the remaining stump of the traumatic amputation.